Individual
SHAWN SOUVENIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.S.
Contact information
Practice address
1210 2ND AVENUE, COLUMBUS, GA 31909
(706) 256-3200
Mailing address
131 MITCHELL RIDGE PL, COLUMBUS, GA 31907-3789
(706) 332-9096
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
04/23/2014
Last updated
04/23/2014
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